picuRN0430

1) what is the most common type of diagnosis? typically in our picu, we see a little bit of everything. a lot of trauma, as i work in a major city, and a lot of respiratory illnesses. also included: rsv, hem/onc, brain tumors, dka, cardiomyopathy, sepsis, esrd pts. on dialysis, hus, ingestion, cv surgical pts, unforunately abuse.. its quiet the variety 2) how often do your pt's "graduate" and get well? i would say 85% of the time, our patients get better and are transferred out of the icu. the other 15% of the time, they are transferred to boston or chop, or they pass away, and very very rarely go home form the icu. 3) what do you think makes you a born picu nurse? (i'm sure its almost impossible to describe but worth a shot!) i think that a born picu nurse loves taking care of very sick children and making a difference in their life. you must pay great attention to detail, be caring, passionate, extremely patient, be very organized, be able to prioritize, and still love the adrenaline rush when things go haywire. 4) do you feel you have the time in your day to take the extra safety precautions that are needed in the pediatric population? safety is the number one concern in a picu. not only do you have a multitude of equipment, but there are families around, who sometimes, may not understand the significance of not laying on top of ventilator tubing, etc. siderails are always up, bed is locked in the lowest position, pt. is restrained if necessary, and pt. is frequently checked by the rn.

i would say HH, they have a level 1 trauma for their ED, and the hospital has Magnet status. they have a lifestar program as well, which you could possibly shadow.

My best friend works at CT Children's and she started somewhere around $27, and after 2 years, is now at $30/hour.

We still suture our CVL's, have changed our catheter related BSI practices a little bit (creating a med-line with a port for blood draws, so as not to access the line as frequent, as well as cleansing techniques) and have found that our rate of BSI has gone down.

In our unit, the charge nurse constantly gets updates on every patient to plan for the next shift, so if the patient was stable overnight, but became really busy during the day, they can plan to make the pt. a 1:1 for the next shift. For the most part, oscillated patient, and surgical CV patients are always 1:1. We have an 18 bed unit and have at least 10 nurses scheduled per shift.

"C" had been in our unit since birth. She was born a twin, with multiple anomalies, including bladder extropy - her twin was fine. She had been through multiple surgeries, and yet still seemed to fight her way through. She was in DCF custody, and her parents never came to visit. Her grandparents were there day in and day out, never failed to miss a day. This little girl had gotten a trach, an ostomy, and had gone through multiple bouts of sepsis and C. Dif. Miraculously at 15 months of age she was started to get much better. She was transitioned off the Servo-I ventilator to the Pulmonetics. She was learning to sign, and was very playful. Her favorite toy was a disposable stethoscope haha. So this past Christmas Eve I worked overnight into Christmas Day. Our Child Life Specialists bring by a life-size stocking for all patients to open Christmas morning, so we brought hers to her early. 0500 we woke her up in her velvet Christmas dress, and she was the happiest I have ever seen her. She had the biggest, toothiest grin you could ever imagine. Her eyes were looking all over her crib not knowing which toy to look at first. I will never forget that. Two days later, she got sick from a line sepsis, and the docs decided she needed a new CVL. While attempting this, her heart went into arrhythmias and she died. It was the saddest day our unit had in a long time because we were her family. I will never forget her.

In our PICU, the oscillated kids are always on sedative/analgesic drips (Fentanyl and Versed), as well as a paralyzing drip (Vecuronium). Our docs don't want any chance of our patients trying to breathe against the vent. We usually stop the paralytic upon transitioning them back to the Servo-I.